Orthokeratology: Benefits, Risks, and Legality for Kids - Ophthalmology

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Orthokeratology, often referred to as "ortho-k," is a non-surgical method of reshaping the cornea to temporarily correct refractive errors such as myopia (nearsightedness). This is achieved through the use of specially designed gas-permeable contact lenses that are worn overnight. The lenses gently flatten the cornea, allowing for clearer vision during the day without the need for glasses or contact lenses.

Benefits of Orthokeratology
1. Vision Correction: The primary benefit is the ability to achieve clear vision during the day without corrective lenses. Many children and adults find this particularly advantageous for sports and other activities.

2. Myopia Control: Recent studies suggest that ortho-k may help slow the progression of myopia in children. This is particularly important as higher degrees of myopia are associated with an increased risk of serious eye conditions later in life, such as retinal detachment and glaucoma.

3. Convenience: For children, not having to wear glasses or contact lenses during the day can be more comfortable and less cumbersome, especially during physical activities.

4. Safety: When properly fitted and monitored by an eye care professional, ortho-k lenses are generally considered safe. They are designed to be worn overnight, which minimizes the risk of lens-related complications that can occur with daytime wear.


Risks of Orthokeratology
1. Corneal Complications: As with any contact lens wear, there is a risk of corneal infections (keratitis) and other complications if the lenses are not cared for properly. It is crucial to follow the eye care professional's instructions regarding lens hygiene and wear schedule.

2. Visual Disturbances: Some users may experience visual disturbances such as halos or glare, especially at night. These symptoms can diminish over time as the eyes adjust to the lenses.

3. Not Permanent: The effects of ortho-k are temporary. If the lenses are not worn regularly, the cornea will gradually return to its original shape, and vision will revert to its previous state.

4. Potential for Over-Correction: In some cases, the cornea may become overly flattened, leading to hyperopia (farsightedness) or other visual issues.


Legality and Regulations
In the United States, orthokeratology is legal and regulated. However, it is essential that the lenses are fitted by a qualified eye care professional, such as an optometrist or ophthalmologist, who has received specialized training in ortho-k. The American Academy of Optometry and the American Optometric Association provide guidelines for safe practice in orthokeratology.


Conclusion
In summary, orthokeratology can be a beneficial option for children with myopia, particularly for those who are active and prefer not to wear glasses during the day. While there are risks associated with its use, many of these can be mitigated through proper fitting, care, and regular follow-up with an eye care professional. It is crucial to have an open discussion with your child's eye doctor about the potential benefits and risks, as well as to ensure that the treatment plan is tailored to your child's specific needs.
If you have concerns about the safety or legality of ortho-k for your daughter, I recommend discussing these with her eye care provider, who can provide personalized advice based on her eye health and vision needs.